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10 High Power Tips To Pass Your MRCGP SCA Exam

The SCA (Simulated Consultation Assessment) exam is one of the 3 components of MRCGP (the other two being AKT and WBPA).

Being a relatively new exam, can understandably create a level of uncertainty and fear. The impact of nerves can often lead to doctors failing to demonstrate their obvious talent, and using more of a scripted approach that completely changes their natural ability to consult.

Below are ten important, but often less discussed tips for this exam – both for preparation, as well as for the day itself – things that we focus heavily on during our SCA Packages and Mocks.

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10 High Power Tips To Pass Your SCA Exam

Before we get started...

To find out more about what the SCA exam is (and how to prepare in general), read our dedicated blog here.

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10 High Power Tips To Pass Your SCA Exam

1) Trust the doctor that you already are

Too many times we role-play with doctors who are trying to be someone else – too many pre-rehearsed lines, adjusting to too many rumours about the exam and too many robotic reactions to natural situations. When asked why this happens the doctor usually replies “I thought this is what they are looking for”.

You have reached the point of SCA by being the doctor that you are – you need to trust this background. You have seen hundreds of patients in your life, dealt with hundreds of different situations and have by now developed your own, competent style. Whilst of course like for any exam you may need to make some adjustments or include or exclude certain things, please don’t feel that you need to start from scratch and become a completely different doctor.

Trusting your natural ability and skills is an important starting point – 80% is already there – don’t start from zero and ‘learn’ what you already know how to do.

10 High Power Tips To Pass Your SCA Exam

2) Don’t become ‘robotic’

Using ‘Scripts’ or rote-learning question lists lead to a formulaic and robotic approach and at worst,  blinds you from key issues in a case.

When an exam is testing your ability to hold a 12-minute consultation there is no way that trying to memorise the whole thing will work. Whilst it is of course helpful to review potential patient presentations, scenarios and situations – and then thinking about possible approaches, key questions and management options – try and keep these as loose frameworks, as opposed to rigid pathways.

Relying on scripts leads to panic when a new situation arises that hasn’t been ‘learned’, as well as you not listening to patients as we think we know where we’re going. Focusing more on key issues that present themselves and trusting your ability to adapt is a must. It is also recognised that there  is no single or preferred model for GP consultations – they are complex, with many factors interacting in unpredictable ways – all which are likely to be assessed in this exam.

For an ideal approach to data gathering, watch this short video

10 High Power Tips To Pass Your SCA Exam

3) Always show RELEVANCE

Data gathering is not done just for the sake of getting data. It is not only important what you ask (most doctors will end up asking similar core questions in the end) – it is important how you ask them.

Two people can ask the same question – for example about smoking – but one will look forced and the other natural. The key difference is relevance. Linking questions to the symptom or condition can help show that everything you ask is for a reason. For example, “Slightly odd question Mrs. X – sometimes indigestion can be made worse by habits such as smoking – can I check if you do this by any chance?” is much better than “can I ask if you smoke Mrs. X?”. Bring the symptom or condition back as many times as you can in data gathering to show continued relevance for everything that you’re doing. 

Relevance is one of the 3 ‘Arora R’s of Interpersonal’ – for more details watch this short video.

10 High Power Tips To Pass Your SCA Exam

4) Don’t forget the medicine

Remember that the purpose of this exam primarily is to test your ability to integrate and apply clinical skills to safely managing a situation in general practice. Don’t focus excessively on how you’re doing things that you forget to do the correct thing in the first place!

The RCGP have stated that the following should be demonstrated:

  • Patients are kept safe
  • GPs can be adaptable in treating different types of patients and illnesses
  • GPs can manage risk, complexity and uncertainty
  • GPs exhibit appropriate behaviours, attitudes and concerns for their patients

After this exam you will be a fully qualified GP making clinical decisions on your own – making sure your clinical judgement and abilities are sound has to be a priority for this assessment – know your guidelines, know your red flags, know your treatments.

10 High Power Tips To Pass Your SCA Exam

5) Reflect and acknowledge

Reflection and acknowledgement of cues, emotions and patient reactions is always important. Reflection and acknowledgment, for example “I can see how you may be worried about that” or “I can see that you look very embarrassed” not only makes it clear that you have picked up the potential cue, it allows rapport to be built.

If a patient tells you something important to them – for example their worry about a cancer, or difficulties with their boss at work or that this situation really frightens them, and you DON’T reflect or acknowledge that, a large hole may appear in the consultation – also appearing very doctor-centred.

Get into the habit of reflecting things back there and then – and watch how your consultations flow more smoothly.

10 High Power Tips To Pass Your SCA Exam

6) Organise EARLY in management

The first minute of management often signals the shift from patient-time to doctor-time.

The first minute can eloquently set up the remainder of the case – make it work for you and think about what you need to demonstrate in the next few minutes. Find a way to demonstrate your understanding of the case early in management – show that you understand the issues going on in this SITUATION as opposed to just the CONDITION.

Management needs to highlight that everything that you did in data gathering was important and understood – getting the first minute of management right can go a long way to achieving this. The concept of putting ‘issues on the table’ is something that we discuss in our SCA packages and mocks to provide a nice structure to your management component of the consultation.

This video covers the ‘Arora Golden 1st Minute of Management’ in more detail.

10 High Power Tips To Pass Your SCA Exam

7) Don’t put everything on finishing the case

Please don’t aim to completely manage every single issue in the consultation.

Some cases are likely to be complex and you will be expected to showcase your ability of managing multiple issues.  Remember your aim – by the end of this case I need to have a) understood all key issues going on (medical, psychosocial, fears, ethical etc) and b) demonstrated that I am able to manage the whole situation safely and take it forward appropriately as per the NICE CKS guidelines – not necessarily having COMPLETELY managed everything. 

10 High Power Tips To Pass Your SCA Exam

8) Let the role-player help if they can

Often role-players can be seen solely as the route to the examiner. We are ‘talking’ to the patient but what is being said seems clearly for the examiner’s benefit. Remember the role-player often knows all the key points of the case themself – what the key issues are, which areas need discussing and which don’t, which cues are important etc. If cues are picked up and acted on appropriately, they can help guide you down paths that need expanding on or can try and divert you away from paths that are not being assessed.

Often we can be so sure of what we think the right path is, the subtle hints and cues fall on deaf ears. The role-player will help you, but only if you listen and let them.

10 High Power Tips To Pass Your SCA Exam

9) Challenge each other

Often practice role-plays taking place amongst friends can be a relaxed environment – food and chat, mixed with a few cases. Even the role-players themselves are friendly – information given too easily, breaking into laughter when trying to play an angry patient, overly-positive feedback etc. Make sure you act well for each other – put a little emotion into the case, add in a little challenge. Aim for the exam to feel like a ‘step-down’ rather than a ‘step-up’ from what you’ve been practicing.

Be disciplined with your precious time with each other and make the practicing really worth it.

Read this blog for more tips for practicing with friends and colleagues.

10 High Power Tips To Pass Your SCA Exam

10) Know you’re going to pass

Naturally you are likely to have some nerves towards this exam but too often people are saying ‘I’ll never pass SCA’ or ‘I’ll never cover all of this’. Whilst wishing to pass won’t automatically make it happen, there is definitely something in favour of self-belief. 

Confidence is a key part of passing any exam – regularly telling yourself that you won’t pass, that you can’t pass, but somehow hoping that you will, just makes your preparation that much harder. Regular pep-talks, reminding yourself that you actually know a huge amount and convincing yourself that you will easily pass, will push you that bit harder.

Yes this is a challenging exam, but it is one that you have been gearing up for a long time. All the time spent preparing will pay off – you just need to believe it for it to show on the day. Focus on the positive end-point and you’ll reach it much more easily.

10 High Power Tips To Pass Your SCA Exam

How Arora can help you Pass SCA

Our most comprehensive SCA package is our SCA Ultimate Package – saving you time and planning. All of our SCA resources and material are included in this mega-bundle: SCA-145 Online video course, 3x SCA Audiobook courses, Live Mini-SCA Mock Exam session, Online Case Bank, Data Gathering Flashcards and Medical ‘How to Explain’ Flashcards. Access to all material is for 12 months allowing for a complete preparation plan. It will cover key aspects of SCA preparation – balancing both scoring high marks and effective time management, in 5 different teaching styles to suit each type of learning. Click here for full details and samples.

All of our individual SCA resources and packages are here.

To register for our next free SCA Booster webinar click here.

To join our SCA Telegram teaching group for daily teaching click here.

10 High Power Tips To Pass Your SCA Exam

And on a Final Note…

SCA preparation is important. It is not just about reviewing day-to-day patients, doing multiple practice role-plays and reading multiple notes for months on end.

Figuring out your strengths and weaknesses early, understanding what is being assessed and tackling your preparation in an organised way are keys to success.

I look forward to meeting you soon and good luck with preparation!

#CanPassWillPass

Author Bio — Dr Aman Arora

Dr Aman Arora is a GP who is now 100% committed to transforming medical education, helping doctors across the globe to ace their exams and enhance their careers. He is proud to hold FRCGP (Fellow of Royal College of General Practitioners). Read more about Dr Aman’s journey here.

Previous roles include:

  • GP Training Programme Director
  • HEWM Advanced MRCGP AKT Trainer
  • GMC PLAB 2 Examiner
  • NHS GP Appraiser
  • MSRA Question-writer
  • GP Recruitment Examiner
  • HEWM IMG Board Member
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Author Bio — Dr Pooja Arora

Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).

You can find out more about Pooja’s previous roles and qualifications here.

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